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Legislative Study on the Mitigation of the Burden of Proof in Hospital Infection Cases - Focusing on the revised Bürgerliches Gesetzbuch - (병원감염 사건에서 증명책임 완화에 관한 입법적 고찰 - 개정 독일민법을 중심으로 -)

  • Yoo, Hyun Jung
    • The Korean Society of Law and Medicine
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    • v.16 no.2
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    • pp.159-193
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    • 2015
  • Owing to causes such as population aging, increased use of various medical devices, long-term hospitalization of various patients with reduced immune function such as cancer, diabetes, and organ transplant patients, and the growing size of hospitals, hospital infections are continuing to increase. As seen in the MERS crisis of 2015, hospital infections have become a social and national problem. In order to prevent damage due to such hospital infections, it is necessary to first strictly implement measures to prevent hospital infections, while, on the other hand, providing proper relief of damage suffered due to hospital infections. However, the mainstream attitude of judicial precedents relating to hospital infection cases has been judged to in fact shift responsibility over damages due to hospital infections on the patient. In light of the philosophy of the damage compensation system, whose guiding principle if the fair and proper apportionment of damages, there is a need to seek means of drastically relaxing the burden of proof on the patient's side relative to conventional legal principles for relaxing the burden of proof, or the theory of de facto estimation. In relation to such need, the German civil code (Burgerliches Gesetzbuch), which defines contracts of medical treatment as typical contracts under the civil code, and has presumption of negligence provisions stipulating that, in cases such as hospital infections which were completely under the control of the medical care providers, if risks in general medical treatment have been realized which cause violations of the life, body, or health of patients, error on the part of the person providing medical care is presumed, was examined. Contracts of medical treatment are entered into very frequently and broadly in the everyday lives of the general public, with various disputes owing thereto arising. Therefore, it is necessary to, by defining contracts of medical treatment as typical contracts under the civil code, regulate the content of said contracts, as well as the proof of burden when disputes arise. If stipulations in the civil code are premature as of yet, an option may be to regulate through a special act, as is the case with France. In the case of hospital infection cases, it is thought that 'legal presumption of negligence' relating to 'negligence in the occurrence of hospital infections,' which will create a state close to equality of arms, will aid the resolution of the realistic issue of the de facto impossibility of remedying damages occurring due to negligence in the process of occurrence of hospital infections. Also, even if negligence is presumed by law, as the patient side is burdened with proving the causal relationships, such drastic confusion as would occur if the medical care provider side is found fully liable if a hospital infection occurs may be avoided. It is thought that, alongside such efforts, social insurance policy must be improved so as to cover the expenses of medical institutions having strictly implemented efforts to prevent hospital infections in the event that they have suffered damages due to a hospital infection accident, and that close future research and examination into this matter will be required.

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Combined Effects of Filter-feeding Bivalve and Zooplankton on the Growth Inhibition of Cyanobacterium Microcystis aeruginosa (남세균 제어를 위한 동물플랑크톤(Daphnia magna)과 패류(Unio douglasiae)의 단독 및 혼합적용)

  • Kim, Nan-Young;Park, Myung-Hwan;Hwang, Su-Ok;Kim, Baik-Ho;Hwang, Soon-Jin
    • Korean Journal of Ecology and Environment
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    • v.48 no.2
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    • pp.108-114
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    • 2015
  • Single - and combined effects of a domestic freshwater bivalve Unio douglasiae (7.6~8.6 cm in shell length) and zooplankton Daphnia magna (1~2 mm in body size) were examined to understand whether they inhibit the growth of harmful cyanobacterial bloom (i.e. Microcystis aeruginosa) in a eutrophic lake. The experiments were triplicated with twelve glass aquaria (40 L in volume); three aquaria without mussel and zooplankton, served as a control, three zooplankton aquaria (Z, density=40 indiv. $L^{-1}$), three mussel aquaria (M, density=0.5 indiv. $L^{-1}$), and three mussel plus zooplankton aquarium (ZM, density=40 indiv.Z $L^{-1}$ plus 0.5 indiv.M/L), respectively. Algal growth inhibition (%) calculated as a difference in the concentration of chlorophyll-a (Chl-a) before and after treatment. Chl-a in all aquaria decreased with the time, while a greatest algal inhibition was seen in the ZM aquaria. After 24 hrs of incubation, Chl-a concentration at the mid-depth (ca. 15 cm) in ZM aquaria reduced by 90.8% of the control, while 63.2% and 79.8% in Z and M aquaria, respectively. Interestingly, during the same period, the surface Chl-a was diminished by 51.9% and 65.4% relative to the control in Z and ZM aquaria, while 27.4% of initial concentration decreased in M aquarium, respectively. These results suggest that 1) this domestic freshwater filter-feeding bivalve plays a significant role in the control of cyanobacterial bloom (M. aeruginosa), and 2) the combination with zooplankton and mussel has a synergistic effect to diminish them, compared to the single treatment of zooplankton and mussel.

Effect of Low Light Intensity after Fruit Set on the Growth and Quality of Cucumber(Cucumis sativus cv. Hyakunari-3). (착과기 이후의 약공 조건이 백침게 오이의 생육반응 및 품질에 미치는 영향)

  • Seong, Ki-Cheol;Moon, Gi-Hye;Lee, Sang-Gyu;Kang, Yong-Gu;Kim, Kwang-Yong;Seo, Hyo-Duck
    • Journal of Bio-Environment Control
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    • v.13 no.1
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    • pp.44-50
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    • 2004
  • This experiment was conducted to investigate the effects of different levels of light intensity (100, 200, 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$, and natural light) on the growth and the fruit quality of cucumber(Cucumis sativus cv. Hyakunari-3). The results of this experiment indicated that plant height and length of lateral shoots were decreased under low light condition, but it was not significantly different among treatments. Leaf area and root weight were lowest under low light intensity(100 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$), but no significant differences were noted between 200 and 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$. Photosynthesis rate was decreased with reduced light intensity and total chlorophyll contents, root activity and xylem sap were also decreased under low light intensity, but there was no significant difference between 200 and 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$. From the SEM observation the erosion of the guard cells and closed stomata in low light treatment were shown and the size of stoma were small also the stomatal aperture were decreased with reducing the light intensity. Chlorosis in leaves and aborted-liked fruits were appeared under low light condition and Ca and Mg uptake in leaves were decreased by shading in proportion to the decrease of light intensity. Fruit yields were decreased by 65% under 400 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$, and by 80${\sim}$90% under 200 and 100 ${\mu}mol\;{\codt}\;m^{-2}\;{\cdot}\;s^{-1}$, compared to those under the natural light. This low intensity of light caused the sharp decrease in the early harvested yields within two weeks and the fruit yields of lateral shoots were greatly decreased.

Evaluation of the Usefulness for VMAT of multiple brain metastasis using jaw tracking (Jaw tracking을 이용한 다발성 뇌 전이의 용적세기조절회전치료에 대한 유용성 평가)

  • Kim, Tae Won;Yoo, Soon Mi;Jeon, Soo Dong;Yoon, In Ha;Back, Geum Mun
    • The Journal of Korean Society for Radiation Therapy
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    • v.30 no.1_2
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    • pp.73-81
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    • 2018
  • Purpose : The aims of this study were to compare and assess the effectiveness of Volumetric Modulated Arc Therapy(VMAT) using jaw tracking(JT) and fixed jaw(FJ) in radiation therapy of multiple brain metastasis. Methode and material : Among the patients with Multiple Brain Metastasis treated with jaw tracking, 10 patients with more than 6 tumors and with the size of radiation field $14{\times}14cm^2$ or more were included. Each Treatment plans with jaw tracking(JT) and fixed jaw(FJ) was established with Eclipse (Ver. 13.6 Varian, USA). Gamma Index (3 mm, 3 % confidence interval - 95 %) and maximum dose difference were measured with an electronic portal imaging device(EPID). The $D_{max}$ and $D_{mean}$ of Organ At Risk(OAR) were assessed and compared, and the Conformity Index(CI) and Homogeneity Index(HI) were evaluated. Result : Evaluating jaw tracking(JT) and fixed jaw(FJ) outcomes, in all cases, Gamma Index met the permissible standard of 3 mm, 3 % confidence intervals of 95 %. The maximum dose difference value from the areas with leaf end transmission was measured at a maximum of 98.4 % and an average of 43.6 % in clockwise(CW), and 67.9 % and 41.0 % for each in Counter-Clockwise(CCW). With jaw tracking, the maximum value of $D_{max}$ for each normal organ in OAR decreased in 15.36 %~74.59 % with the average value decreasing in 2.84 %~39.80 %. The maximum value of $D_{mean}$ in OAR decreased in 27.90 %~65.23 %, with the average value decreasing in 7.70 %~41.71 %. No change has been found in Conformity Index and Homogeneity Index values. Conclusion : When Jaw tracking is used in treating patients with multiple brain metastasis with VMAT, the unnecessary exposure due to leakage and transmission of radiation in unspecified areas was reduced, without affecting the dose distribution of the planning target volume(PTV), and the availability of radiation therapy with lower doses in normal organs is expected.

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Estimation of TROPOMI-derived Ground-level SO2 Concentrations Using Machine Learning Over East Asia (기계학습을 활용한 동아시아 지역의 TROPOMI 기반 SO2 지상농도 추정)

  • Choi, Hyunyoung;Kang, Yoojin;Im, Jungho
    • Korean Journal of Remote Sensing
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    • v.37 no.2
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    • pp.275-290
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    • 2021
  • Sulfur dioxide (SO2) in the atmosphere is mainly generated from anthropogenic emission sources. It forms ultra-fine particulate matter through chemical reaction and has harmful effect on both the environment and human health. In particular, ground-level SO2 concentrations are closely related to human activities. Satellite observations such as TROPOMI (TROPOspheric Monitoring Instrument)-derived column density data can provide spatially continuous monitoring of ground-level SO2 concentrations. This study aims to propose a 2-step residual corrected model to estimate ground-level SO2 concentrations through the synergistic use of satellite data and numerical model output. Random forest machine learning was adopted in the 2-step residual corrected model. The proposed model was evaluated through three cross-validations (i.e., random, spatial and temporal). The results showed that the model produced slopes of 1.14-1.25, R values of 0.55-0.65, and relative root-mean-square-error of 58-63%, which were improved by 10% for slopes and 3% for R and rRMSE when compared to the model without residual correction. The model performance by country was slightly reduced in Japan, often resulting in overestimation, where the sample size was small, and the concentration level was relatively low. The spatial and temporal distributions of SO2 produced by the model agreed with those of the in-situ measurements, especially over Yangtze River Delta in China and Seoul Metropolitan Area in South Korea, which are highly dependent on the characteristics of anthropogenic emission sources. The model proposed in this study can be used for long-term monitoring of ground-level SO2 concentrations on both the spatial and temporal domains.

Effects of Seasonal Wiring Treatments on Fruit Quality, Carbohydrates, and Mineral Nutrients of 'Niitaka' (Pyrus pyrifolia Nakai) Pear Trees (시기별 Wiring 처리가 '신고' 배의 과실품질 및 수체 내 탄수화물과 무기성분에 미치는 영향)

  • Seo, In-Ho;Song, Jang-Hoon;Seo, Ho-Jin
    • Korean Journal of Organic Agriculture
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    • v.27 no.1
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    • pp.33-44
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    • 2019
  • This study was initiated to find possibility of substitute of gibberellin acid and to prevent negative girdling effect such as slow growth of 'Niitaka' (Pyrus pyrifolia Nakai) trees, a major pear cultivar, at harvest and at 60-, 90-, and 120-d after storage. Seasonal wiring with 3.0-mm-diameter were applied on the main branch at 70, 80, 90, 110, and 130 days after full bloom (DAF) to compare the fruit quality and storability. Fruit weight and sugar contents were the greatly increased by the wiring treatment at 110 DAF, with the lowest values observed for the wiring at 70 DAF. All the wiring treatments reduced fruit acidity but did not affect fruit firmness. a-value on fruit skin was the highest for wiring at 110 DAF and 130 DAF, advancing fruit ripening. The lowest fruit weight loss was occurred at wiring at 110 DAF. a-value on fruit skin was the highest for wiring at 90 DAF and 110 DAF. Wiring at 80 DAF the most increased floral bud diameter, resulting in the lowest L:D ratio of 1.74 observed. As for the mineral nutrients concentrations of floral buds, the concentration of K (0.63%) and Mg (0.31%) were the highest after 80 DAF wiring treatment, whereas Ca and P concentrations did not differ among treatment plots. The leaf K concentrations was the highest in the 130-day wiring treatment (0.76%) and in the control plot (0.78%), whereas there was no significant difference in the concentrations of either Ca or P among treatment plots. Short periods of wiring increased foliar Mg concentrations. In floral buds, carbohydrates showed a tendency for accumulating at a lower concentrations (7.75%) after 70 DAF wiring treatment, which was a relatively short treatment period. On the other hand, the carbohydrate concentrations in leaves showed a tendency for accumulating at lower concentrations after 130 DAF wiring treatment (2.51%), which is a long treatment period, and in the control plot (2.43%). Wiring increased the size and sugar content of fruits, and influenced fruit storability. For the wiring treatment period was delayed, the carbohydrate concentration in flower buds showed curvilinear correlation and the negative correlation with the carbohydrate in leaf tissue.

Impact of Entrepreneurial Business Start-up Motivation, Entrepreneurial Spirit, and Entrepreneurial Competence Characteristics on Start-up Companies' Sustainability: Focusing on the Mediating Effect of the Start-up Companies' Business Performance (창업자의 창업동기, 창업가정신 그리고 창업가 역량특성이 창업기업 지속가능성에 미치는 영향: 창업기업 경영성과를 매개로 하여)

  • Hyuk, Kang Han;Park, Woojin;Yun, Bae byung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.14 no.3
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    • pp.59-71
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    • 2019
  • The domestic unemployment rate is now seriously increasing due to the impact of the international trend of incurring high costs using only a small number of manpower in a situation where the business has been being reduced in size. The nation is taking start-up promotion policies as a way to overcome the problem, but with the advent of excessive entrepreneurs and their concentration on specific areas, their survival is in an unclear situation. Thus, this study was intended to provide a useful direction for successful start-ups by identifying the impact of entrepreneurial motivation and entrepreneurship, internal characteristics of entrepreneurs, and of competency characteristics, external characteristics of them, on sustainability through business performance. Thus, the purpose of this study was to provide a useful direction for successful start-ups by identifying the impact of entrepreneurial motivation and entrepreneurship, internal characteristics of entrepreneurs, competency, and external characteristics, on sustainability through business performance. The result of verifying the hypothesis has showed that entrepreneurial motivation, entrepreneurship, and competency characteristics had a positive effect on business performance, and on the other hand, the business performance had a positive effect on sustainability. In addition, in terms of the impact of entrepreneurial motivation, entrepreneurship, and competency characteristics on sustainability, all of them had mediating effects on business performance. It is obvious that studies on the factors affecting business performance and corporate sustainability up to now have been carried out by only collecting the independent variables of this study individually or two of them. so it is judged that if the study, which has verified the practical direction in general through the verification of entrepreneurs's internal and external characteristics from various angles, is performed more comprehensively along with the addition of background characteristics of entrepreneurs, such as characteristics of start-up preparation, etc., in the future, more in-depth results will be able to be obtained.

Effects of environmental enrichments on performance and behavior characteristics of sows during gestating period (환경보조물이 임신모돈의 생산성 및 행동특성에 미치는 영향)

  • Jeong, Yong-Dae;Kim, Doo-Wan;Min, Ye-Jin;Jung, Hyun-Jung;Cho, Eun-Seok;Kim, Young-Hwa
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.428-434
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    • 2019
  • Many countries have interested animal welfare. Similarly, domestic people have concern for the welfare from companion animals to livestock. Environmental enrichments (EE) are tool to enforce the welfare, however, research with sows is limited. Therefore, this study was investigate to effects of environmental enrichments on performance and behavior properties of gestating sows. A total of 30 pregnant sows (Landrace) were assigned into three treatments that control, T1 (plastic device) and T2 (Rice straw). Period of trial was from Mar. 03. 18. to Mary 19. 18. The EE were allotted to center of experimental pen ($11.6{\times}6.0m$). Body weight (BW), backfat thickness (BF) and cortisol were identified at experimental initial or end date. Behavior was recorded during 24 hours on days 91 of gestation, and then analyzed the patterns. BF was reduced (15.73 vs. 16.56 mm; p>0.05) in T1 than control, but Ending BW, total litter size and alive piglets did not differ. Born dead piglets showed lower tendency (1.00 and 0.63 vs. 1.50 heads; p>0.05) in T1 and T2 than control. Similarly, the enrichments declined farrowing mortality (C, 8.68%; T1, 6.86%; T2, 3.40%; p>0.05). Cortisol was not differed among treatments. In the behavior characteristics, eating showed lower (1.81 vs. 9.68 and 6.99%; p<0.05) in T2 than control and T1. Furthermore, playing or digging were only observed (0.33 and 2.10%; p<0.05) in T1 and T2, respectively, whereas rubbing (0.91%, p<0.05) only showed in the control. These results suggest that the provision of EE would be not negatively affected the performance of the gestating sows and could be led to improvement of the livestock welfare.

Truncation Artifact Reduction Using Weighted Normalization Method in Prototype R/F Chest Digital Tomosynthesis (CDT) System (프로토타입 R/F 흉부 디지털 단층영상합성장치 시스템에서 잘림 아티팩트 감소를 위한 가중 정규화 접근법에 대한 연구)

  • Son, Junyoung;Choi, Sunghoon;Lee, Donghoon;Kim, Hee-Joung
    • Journal of the Korean Society of Radiology
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    • v.13 no.1
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    • pp.111-118
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    • 2019
  • Chest digital tomosynthesis has become a practical imaging modality because it can solve the problem of anatomy overlapping in conventional chest radiography. However, because of both limited scan angle and finite-size detector, a portion of chest cannot be represented in some or all of the projection. These bring a discontinuity in intensity across the field of view boundaries in the reconstructed slices, which we refer to as the truncation artifacts. The purpose of this study was to reduce truncation artifacts using a weighted normalization approach and to investigate the performance of this approach for our prototype chest digital tomosynthesis system. The system source-to-image distance was 1100 mm, and the center of rotation of X-ray source was located on 100 mm above the detector surface. After obtaining 41 projection views with ${\pm}20^{\circ}$ degrees, tomosynthesis slices were reconstructed with the filtered back projection algorithm. For quantitative evaluation, peak signal to noise ratio and structure similarity index values were evaluated after reconstructing reference image using simulation, and mean value of specific direction values was evaluated using real data. Simulation results showed that the peak signal to noise ratio and structure similarity index was improved respectively. In the case of the experimental results showed that the effect of artifact in the mean value of specific direction of the reconstructed image was reduced. In conclusion, the weighted normalization method improves the quality of image by reducing truncation artifacts. These results suggested that weighted normalization method could improve the image quality of chest digital tomosynthesis.

Surface Change Detection in the March 5Youth Mine Using Sentinel-1 Interferometric SAR Coherence Imagery (Sentinel-1 InSAR 긴밀도 영상을 이용한 3월5일청년광산의 지표 변화 탐지)

  • Moon, Jihyun;Kim, Geunyoung;Lee, Hoonyol
    • Korean Journal of Remote Sensing
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    • v.37 no.3
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    • pp.531-542
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    • 2021
  • Open-pit mines require constant monitoring as they can cause surface changes and environmental disturbances. In open-pit mines, there is little vegetation at the mining site and can be monitored using InSAR (Interferometric Synthetic Aperture Radar) coherence imageries. In this study, activities occurring in mine were analyzed by applying the recently developed InSAR coherence-based NDAI (Normalized Difference Activity Index). The March 5 Youth Mine is a North Korean mine whose development has been expanded since 2008. NDAI analysis was performed with InSAR coherence imageries obtained using Sentinel-1 SAR images taken at 12-day intervals in the March 5 Youth Mine. First, the area where the elevation decreased by about 75.24 m and increased by about 9.85 m over the 14 years from 2000 was defined as the mining site and the tailings piles. Then, the NDAI images were used for time series analysis at various time intervals. Over the entire period (2017-2019), average mining activity was relatively active at the center of the mining area. In order to find out more detailed changes in the surface activity of the mine, the time interval was reduced and the activity was observed over a 1-year period. In 2017, we analyzed changes in mining operations before and after artificial earthquakes based on seismic data and NDAI images. After the large-scale blasting that occurred on 30 April 2017, activity was detected west of the mining area. It is estimated that the size of the mining area was enlarged by two blasts on 30 September 2017. The time-averaged NDAI images used to perform detailed time-series analysis were generated over a period of 1 year and 4 months, and then composited into RGB images. Annual analysis of activity confirmed an active region in the northeast of the mining area in 2018 and found the characteristic activity of the expansion of tailings piles in 2019. Time series analysis using NDAI was able to detect random surface changes in open-pit mines that are difficult to identify with optical images. Especially in areas where in situ data is not available, remote sensing can effectively perform mining activity analysis.